CON Summer Salary Award Report version January 2008

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Summer Salary Award Report Subsection: Appendix F2
Section - Information Originating Date: December, 2007
Responsible Reviewing Agency:
Executive Council
Revised: January, 2008
J:/RESOURCE MANUAL/Table of Contents College of Nursing Resource Manual


Submit 1 copy to Division Assistant Dean or Department Chairperson by 5 p.m. Friday Sept. 5, 2008 for signature.

Submit 1 copy, signed or forwarded on email by the Division Assistant Dean or Department Chairperson, to Chairperson of Summer Salary Committee – (M.J. Stanley, Lincoln Division) by 5 p.m. Friday Sept. 12, 2008

Name(s):   Division or Dept:

[Individuals working together on one project in one course can submit one report with all names]

Title of Project:

Number of approved days ______
Approximate number of days you actually spent completing this project: _________

Outcome (Product)
For each outcome identified on your application or modified by Summer Salary Committee in notification letter, describe if you accomplished it or the progress you made. For tangible outcomes please submit a copy of it. [e.g. if the outcome was to be NCLEX and Blooms’ mapping of test items, then attach the Test Blueprint for the course you did and also indicate how many new test items you developed to achieve the desired relative proportions within the blueprint – For security purposes Do Not Attach Exam Questions; if outcome was to develop a new Sim Man Scenario, attach the printed scenario, list of necessary supplies, and computer print out
Cross Campus: Indicate if any coordination with cross campus faculty occurred with their names and campus- if applicable:

Progress Toward Implementation on Own Campus

Progress Toward Demonstration and/or Implementation on All Campuses

Progress Toward Evaluation of the Project

[Note: If implementation and evaluation has not yet been accomplished, a follow-up report will be necessary to Dept. Chairperson/Division Assistant Dean].

Additional Support (technical, additional equipment, etc.).
Indicate if additional support was used.
Indicate if additional support was needed, but not available:
Please describe any suggestions for improving the process for summer salary awards:

Please indicate anything else you wish the Summer Salary Committee to know.

____________________________________________       _______________________
Signature of Faculty Member
    Or email from faculty member
____________________________________________       _______________________
Signature of Dept. Chair or Division Assistant Dean
    Or notification of approval by forwarding on email by 9/12/08